背景:多发性硬化症(MS)是年轻人残疾的最常见原因之一。流动性损害,主要与步态和平衡有关,被列为MS(PwMS)患者中最关注的问题。步态和平衡功能障碍可直接影响PwMS患者的生活质量和日常生活活动能力,因此,有效治疗策略的重要性。以前的研究已经证明了各种非药物康复方法的积极作用,包括物理治疗和电刺激,PwMS中的步态和移动性。非药理学方法可以根据每个患者的个人需求和能力进行定制,允许医疗保健提供者创建个性化的培训计划。此外,这些方法通常导致最小或没有副作用。
目的:这篇综述全面概述了一系列旨在提高PwMS患者的非药物治疗方法。
方法:我们对PubMed,研究不同非医学方法对PwMS步态和平衡性能的影响。审查的治疗方法包括“锻炼”,身体康复,双任务(DT)康复,机器人辅助康复,虚拟现实辅助康复,游戏训练,电刺激装置,听觉刺激,视觉反馈,和鞋垫\”。
结论:对80篇文章进行了细致的回顾。我们的研究强调了非药物干预对患者生活质量的积极影响,减少残疾,疲劳,肌肉痉挛.虽然有些方法,包括运动和物理治疗,显示出实质性的希望,需要进一步的研究来评估视觉生物反馈和听觉刺激是否优于常规方法.此外,方法,如功能性电刺激,非侵入性脑刺激,鞋垫显示出巨大的短期益处,促使进一步调查其长期影响。非药物干预可以作为基于药物的方法的有价值的补充。
BACKGROUND: Multiple Sclerosis (MS) is among the most common reasons for disability in young adults. Mobility impairment, primarily related to gait and balance, is ranked as the preeminent concern among persons with MS (PwMS). Gait and balance dysfunction can directly affect the quality of life and activities of daily life in PwMS, hence the importance of effective treatment strategies. Previous studies have demonstrated the positive effect of various non-pharmacological rehabilitation methods, including physiotherapy and electrical stimulation, on gait and mobility in PwMS. Non-pharmacological methods can be tailored to the individual needs and abilities of each patient, allowing healthcare providers to create personalized training programs. Furthermore, these methods typically result in minimal or no side effects.
OBJECTIVE: This
review provides a comprehensive overview of an array of non-pharmacological treatment approaches aimed at enhancing ambulatory performance in PwMS.
METHODS: We performed a narrative
review of the original papers available in PubMed, investigating the effects of different nonmedical approaches on the gait and balance performance of the PwMS. Reviewed treatment approaches include \"exercise, physical rehabilitation, dual-task (DT) rehabilitation, robot-assisted rehabilitation, virtual reality-assisted rehabilitation, game training, electrical stimulation devices, auditory stimulation, visual feedback, and shoe insoles\".
CONCLUSIONS: Eighty articles were meticulously reviewed. Our study highlights the positive effects of non-pharmacological interventions on patients\' quality of life, reducing disability, fatigue, and muscle spasticity. While some methods, including exercise and physiotherapy, showed substantial promise, further research is needed to evaluate whether visual biofeedback and auditory stimulation are preferable over conventional approaches. Additionally, approaches such as functional electrical stimulation, non-invasive brain stimulation, and shoe insoles demonstrate substantial short-term benefits, prompting further investigation into their long-term effects. Non-pharmacological interventions can serve as a valuable complement to medication-based approaches.